title: Pegylated liposomal doxorubicin in combination with low-dose metronomic cyclophosphamide as preoperative treatment for patients with locally advanced breast cancer.
abstract: OBJECTIVE
  To evaluate the role of pegylated liposomal doxorubicin with low-dose metronomic cyclophosphamide as primary systemic treatment in locally advanced breast cancer.
  
  
  METHODS
  The activity and safety of intravenous pegylated liposomal doxorubicin 20 mg sqm(-1) biweekly for eight courses in combination with metronomic cyclophosphamide 50 mg day(-1) orally were evaluated in 29 patients with locally advanced breast cancer who were not suitable to receive a standard chemotherapy due to age or co-morbidities or who asked for a regimen with low incidence of toxic effects irrespective of age.
  
  
  RESULTS
  The rate of breast-conserving surgery was 44.8%. Eighteen patients (62.1%) achieved a partial response (including one pathological complete response), 10 (34.5%) a stable disease and one patient experienced a progressive disease. Treatment was well tolerated, with no grade 4 toxicities, and with grade 3 skin toxicity in three patients and hand-foot syndrome in four patients.
  
  
  CONCLUSIONS
  The regimen was well tolerated but with limited activity in the preoperative setting. Other options (e.g., endocrine therapy in estrogen receptor -positive disease) should be considered in locally advanced breast cancer patients who are not suitable to receive a standard chemotherapy.
authors.affiliation: Medical Senology Research Unit, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. silvia.dellapasqua@ieo.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Dellapasqua
authors.forename: Manuelita
authors.initials: M
authors.lastname: Mazza
authors.forename: Debora
authors.initials: D
authors.lastname: Rosa
authors.forename: Raffaella
authors.initials: R
authors.lastname: Ghisini
authors.forename: Eloise
authors.initials: E
authors.lastname: Scarano
authors.forename: Rosalba
authors.initials: R
authors.lastname: Torrisi
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Enrico
authors.initials: E
authors.lastname: Cassano
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011292:Premedication; D016896:Treatment Outcome
chemical_list: C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin; D003520:Cyclophosphamide